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Feature

A person washing his hands.

Excessive and ritualistic hand washing is one of the most common manifestations of obsessive compulsive disorder (OCD).

Possible relief for obsessive compulsive disorder: a new study may help quell fe

a new study may help quell fears

By Martha Coventry

From M, winter 2005

Obsessive compulsive disorder (OCD) disturbs about 1 in 50 people with excessive worries and fears. Your brain can latch on to an idea and not let go. For example, you may be obsessed by the thought that every drinking glass in the house is infected with germs, you may be haunted by the notion of death, or you may need to have everything around you in perfect order. That's the obsessive side of the illness. The compulsive side is what you do to ease the pain of those constant thoughts. You may wash things that aren't dirty--excessive hand washing is a typical symptom--or line up things along the edge of your desk in just the right way, or count things over and over to bring some sense of order to a life ruled by your repetitive thoughts.

The principle form of treatment for OCD has been cognitive behavioral psychotherapy (CBT) and often doctors prescribe serotonin selective reuptake inhibitors (SSRIs) like Prozac, Paxil, or Celexa. But for the first time ever, University of Minnesota researchers will be doing an OCD study that uses a drug, D-Cycoleserine, for the sole purpose of enhancing psychotherapy. Without the psychotherapy, the drug is useless.

"This study merges neuroscience, psychiatry, and psychology," says Kushner. "They're not in competition with each other, but working together. We're at this wonderful nexus of these three disciplines."

Matt Kushner, associate professor in the University of Minnesota Medical School's Department of Psychiatry, along with Suck Won Kim, director of the department's Impulse Control Disorders Clinic, is heading up the study. He gives an example of how the two therapies can be combined:

A person with OCD will be directly exposed to the things he or she fears, starting with things that are minimally disturbing and working up to the most difficult things, like a public restroom. Then the patient will be prevented from engaging in subsequent ritualistic behavior, like handwashing, for a period of time, says Kushner. This activity will be repeated with hopes that the patient will eventually come to see that there is nothing to fear from the restroom. This is called "extinction learning," says Kushner. The patient is "unlearning" the fear. This cognitive behavioral method has been in place for years, but the new factor will be the use of D-Cycoleserine. What this drug does is enhance the learning process and makes the therapy more effective. Unlike SSRIs, it doesn't lessen the strength of the fear; it accelerates the learning that there is nothing to be afraid of.

"This study merges neuroscience, psychiatry, and psychology," says Kushner. "They're not in competition with each other, but working together. We're at this wonderful nexus of these three disciplines."

Previous studies have shown that D-Cycoleserine combined with psychotherapy for acrophobia (fear of heights) was much more effective than psychotherapy alone. The idea is that it will work as well for OCD. Kushner and Kim are currently looking for research subjects to take part in this study. People who suffer from OCD are encouraged to call 612-273-9868 and find out more information about participating.